Rural/Urban Imbalance

Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania

The aim of this was to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, and to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. [adapted from abstract]

Stakeholder Perceptions of a Nurse Led Walk-In Centre

This study aimed to ascertain the views of key stakeholders on the introduction of a nurse led primary care walk-in center in a rural region of Australia that aimed to fulfill an unmet health care need in the community due to the shortage of general practitioners, meet projected demand for health care services and relieve pressure on the hospital system. [adapted from abstract[

Policy Options to Attract Nurses to Rural Liberia: Evidence from a Discrete Choice Experiment

A discrete choice experiment was used to test how nurses and certified midwives in Liberia would respond to alternative policies being considered by the ministry of health and social welfare to predict the share of nurses and certified midwives who would accept a job in a rural area under different schemes. [from abstract]

Lifecourse Factors and Likelihood of Rural Practice and Emigration: A Survey of Ghanaian Medical Students

The aim of this study was to investigate the contribution of experiential factors across Ghanaian medical students’ lifespans on intent to practice in a rural area and intent to emigrate. [from abstract]

Private Rural Health Providers in Haryana, India: Profiles and Practices

Despite a widespread public health system, the private healthcare sector is the major provider of health care in rural India. This study describes the profile and medical practices of private rural health providers in rural Haryana, India. [from abstract]

Maternal and Newborn Healthcare Providers in Rural Tanzania: In-Depth Interviews on Motivation, Performance and Job Satisfaction

This article describes an exploratory study that asked: what is understood by the term motivation; what encourages and discourages providers of maternal and newborn care in rural areas; and which factors influence their performance and job satisfaction. [adapted from author]

Realist Review and Synthesis of Retention Studies for Health Workers in Rural and Remote Areas

This report uses a realist review, which is a theory-based method, to address the questions of why and how certain rural retention interventions work better in some contexts and fail in others. The report provides strong support for the assertion that a bundle of retention strategies should be used in order to successfully attract and retain health workers in remote and rural areas and provides insight into why interventions that were effective in one setting may or may not produce similar results in another. [adapted from preface]

Student Perception about Working in Rural Nepal after Graduation: A Study among First and Second Year Medical Students

The present study was conducted at KIST Medical College, a private school in the Lalitpur district, to obtain information on student perceptions about working in rural Nepal after graduation. [adapted from abstract]

Medical Student Characteristics Predictive of Intent for Rural Practice

The purpose of this study was to examine the effect of student characteristics previously correlated to choosing rural practice on osteopathic medical students’ intent to practice in a rural setting. [from abstract]

Medical Students' Characteristics as Predictors of Career Practice Location: Retrospective Cohort Study Tracking Graduates of Nepal's First Medical College

The objective of this study was to determine, in one low income country (Nepal), which characteristics of medical students are associated with graduate doctors staying to practise in the country or in its rural areas. [from abstract]

Does the Positive Influence of an Undergraduate Rural Placement Persist into Postgraduate Years?

The purpose of this study was to test whether or not the effects of a seven week rural undergraduate placement for medical students (which showed positive influence on student attitudes to rural health and their intention to practise in a rural settings) persisted into postgraduate years. [adapted from abstract]

Challenges Confronting Clinicians in Rural Acute Care Settings: A Participatory Research Project

The major aims of this study were to better understand the challenges faced by rural acute care clinicians and the impact of these challenges on their capacity to carry out their roles. A secondary aim was to explore and prioritise strategies to address selected challenges. [from introduction]

Issues Affecting Therapist Workforce and Service Delivery in the Disability Sector in Rural and Remote New South Wales, Australia: Perspectives of Policy-Makers, Managers and Senior Therapist

This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. [from abstract]

Rural Nursing Education: A Photovoice Perspective

The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. [from abstract]

Characteristics of Physicians, Their Migration Patterns and Distance: A Longitudinal Study in Hiroshima, Japan

The authors analyzed the flow of all the clinical physicians in Hiroshima Prefecture, Japan, with particular attention to migration to rural and distant places to determine effective workforce policies for rural and remote areas. [adapted from introduction]

Perceived Barriers and Motivating Factors Influencing Student Midwives' Acceptance of Rural Postings in Ghana

The objectives of this study are to determine the perceived barriers and motivators influencing final year midwifery students’ acceptance of rural postings in Ghana. [from abstract]

What Impedes Working in Rural Areas? A Study of Aspiring Doctors In the National Capital Region, India

This study examined the attitudes of and inclination to rural healthcare careers among medical students in India. [from abstract]

What Influences National and Foreign Physicians' Geographic Distribution? An Analysis of Medical Doctors' Residence Location in Portugal

The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policymakers to identify policies to influence it. [from abstract]

Retention of Allied Health Professionals in Rural New South Wales: A Thematic Analysis of Focus Group Discussions

This study aims to identify aspects of recruitment and retention of rural allied health professionals using qualitative methodology to establish the motives and conditions that encourage allied health professionals to practice rurally. [from abstract]

Which Doctor for Primary Health Care? Two Studies from Chhattisgarh, India

This presentation outlines two studies concerning the recruitment and retention of health workers in underserved areas. [adapted from author]

Institute for Rural Health Studies, Hyderabad

This case study reports on how the Institute for Rural Health Studies has managed to provide seamless access to healthcare for thousands of people throughout the state of Andhra Pradesh through both rural clinics and its related programs in the city’s bus station connecting to a network of patient counselors in government hospitals. [from author]

Does the Insufficient Supply of Physicians Worsen Their Urban-Rural Distribution? A Hiroshima-Nagasaki Comparison

Studies have suggested that a rapid increase in physicians does not necessarily change an urban–rural inequity in their distribution. This study applied spatial competition and attraction–repulsion hypotheses to the geographic distribution of physicians during a time of insufficient physician supply in Japan to determine whether an insufficient supply of physicians worsens an inequity. [adapted from abstract]

Extending the Paramedic Role in Rural Australia: A Story of Flexibility and Innovation

This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a rural expanded scope of practice model. The study found that paramedics are increasingly becoming first line primary healthcare providers in small rural communities and developing additional professional responsibilities throughout the cycle of care. [from abstract]

Midwives Service Scheme in Nigeria

This study evaluates the Midwives Service Scheme in Nigeria which engaged newly graduated, unemployed, and retired midwives to work temporarily in rural areas to improve the wide variation between maternal, newborn, and child health indices across geopolitical zones and between urban and rural areas, mostly due to variations in the availability of skilled attendance at birth. [adapted from author]

Can Medical Education in Poor Rural Areas be Cost-Effective and Sustainable: The Case of the Ateneo de Zamboanga University School of Medicine

This study examined the hypothesis that a medical school in a low-resource setting, based on volunteer faculty, can be sustainable and associated with improvement in medical workforce and population health outcomes. [from abstract]

Clinical Decision-Making of Rural Novice Nurses

Because nurses are often the first to triage and begin treatment, especially in rural areas, an understanding of how they make decisions in patient care is important. The purpose of this study was to explore the decision-making experiences of the rural novice nurse. [from author]

Rural Origin Plus a Rural Clinical School Placement is a Significant Predictor of Medical Students' Intentions to Practice Rurally: A Multi-University Study

The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools Program. [from abstract]

Any Body is Better than Nobody? Ethical Questions around Recruiting and/or Retaining Health Professionals in Rural Areas

The objective of this article is to argue that it is important for all stakeholders involved in rural recruitment and/or retention processes to consider their decisions and actions from an ethics perspective. [from abstract]

Increasing the Number of Rural Physicians

This article discusses the issues facing rural physicians, analyzes efforts to recruit and retain them, and outlines what it will require to increase their numbers.

Bright Future for Rural Health: Evidence-Based Policy and Practice in Rural and Remote Australian Health Care

These case studies from accross Austraila show how rural and remote health professionals are making a difference locally and give insights, approaches and solutions to similar challenges or problems faced elsewhere. Evaluated solutions for many pressing health issues are presented as well as two big policy issues: building sustainable rural primary health care services, and responding to an ageing health workforce. [adapted from foreword]